Pregnancy care and perinatal outcomes in pregnant women with a shunt for hydrocephalus

Czech version

Authors: V. Vybíhal ¹; Lukáš Hruban ²; Martin Plevko ¹; Veronika Ťápalová ²; Anna Jouzová ²; Miloš Keřkovský ³; Marek Sova ¹; Pavel Fadrus ¹; Martin Smrčka ¹
Authors‘ workplace: Neurochirurgická klinika LF MU a FN Brno ¹; Gynekologicko-porodnická klinika LF MU a FN Brno ²; Klinika radiologie a nukelární medicíny LF MU a FN Brno ³
Published in: Ceska Gynekol 2024; 89(5): 417-423
Category:
doi: https://doi.org/10.48095/cccg2024417

Overview

The number of patients with an implanted shunt reaching reproductive age and planning pregnancy is increasing thanks to advances in the treatment of hydrocephalus. Changes in the mother‘s organism, which are mainly related to the accumulation of water in the organism and the elevation of intra-abdominal pressure, contribute to the increased incidence of complications during pregnancy and childbirth. Therefore, it is necessary to make a preconception exam and specify pregnancy management, a suitable method of childbirth dealing with potential complications. Possible malfunction of the shunt is solved individually according to the current neurological findings and taking into account the patient‘s overall condition and gestational age. Vaginal delivery is considered safe and preferred by most authors. Primary caesarean section is indicated only in patients with a history of rapidly progressing deterioration of the neurological condition due to shunt malfunction or serious complications related to its impaired shunt function. In an uncomplicated pregnancy with normal values of intracranial pressure, both general and epidural or spinal anesthesia can be used when choosing anesthesia.

Keywords:

hydrocephalus – pregnancy – shunt – ventriculoperitoneal shunt – ventriculoatrial shunt – lumboperitoneal shunt

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ORCID autorů

V. Vybíhal 0000-0002-5154-5591

L. Hruban 0000-0001-8594-2678

M. Plevko 0000-0002-9174-7788

V. Ťápalová 0009-0008-6574-0321

A. Jouzová 0000-0002-1229-4283

M. Keřkovský 0000-0003-0587-9897

M. Sova 0000-0001-7382-9811

P. Fadrus 0000-0003-3259-1100

M. Smrčka 0000-0002-9191-8700

Doručeno/Submitted: 13. 3. 2024

Přijato/Accepted: 14. 3. 2024